Clin Endosc.  2019 Sep;52(5):506-509. 10.5946/ce.2018.135.

Ascending Colon Cancer with Pathologically Confirmed Tumor Thrombosis of Superior Mesenteric Vein: A Case Report

• Kim SE
• Lee SJ
• Cha JY
• Yi SW
• Kim TS
• Cho IL
• Kwak JY
• Oh KH

• KMID: 2464674
• DOI: http://doi.org/10.5946/ce.2018.135

Abstract

Colon cancer is very rarely accompanied by tumor thrombosis of the superior mesenteric vein (SMV). A 46-year-old patient had been diagnosed with SMV tumor thrombosis related to colon cancer without hepatic metastasis and underwent right hemicolectomy with SMV tumor thrombectomy. Tumor thrombosis was pathologically confirmed as metastatic colon cancer. There has been no recurrence for 12 months with 12 cycles of adjuvant-chemotherapy.

Keyword

Colonic neoplasms; Hepatic metastasis; Superior mesenteric vein tumor thrombosis

MeSH Terms

Colon, Ascending*
Colonic Neoplasms
Humans
Mesenteric Veins*
Middle Aged
Neoplasm Metastasis
Recurrence
Thrombectomy
Thrombosis*

Figure

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  Fig. 1. (A, B) Colonoscopy revealing a protruding mass in the ascending colon. The obstruction of the lumen prevented the endoscope from passing the lesion.

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  Fig. 2. (A) Abdominopelvic computed tomography showing a 9 cm mass in the proximal ascending colon and terminal ileum. (B) Low attenuated lesion in the superior mesenteric vein.

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  Fig. 3. (A) Positron emission tomography-computed tomography showing a hypermetabolic lesion in the proximal ascending colon and terminal ileum (maximal standardized uptake value 24.7). (B) A hypermetabolic lesion in the superior mesenteric vein (maximal standardized uptake value 15.8).

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  Fig. 4. (A) Gross finding showing the tumor thrombus that was removed from the superior mesenteric vein. (B) Microscopic findings of superior mesenteric vein thrombus. Aggregated tumor cells can be observed in the background of fibrinous materials (hematoxylin and eosin, ×200, ×400)

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  Fig. 5. (A) Tumor cells showing weak membranous stains for EGFR (immunohistochemistry, ×200). (B) Nuclei of tumor cells positive for MLH1 (immunohistochemistry, ×200). (C) Nuclei of tumor cells positive for MSH2 (immunohistochemistry, ×200). (D) Nuclei of tumor cells positive for p53 (immunohistochemistry, ×200).

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